Holistic Drama LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4101006577 Issued in MI

Legal business name

HOLISTIC DRAMA LLC

Practice address

340 N Main St Ste 201
Plymouth, MI 48170-1290

Phone

(734) 748-3140

NPI assigned

Mar 23, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenelle Mazaris, LMFTNPI 1700247962

Title

Clinical Director

Phone

(734) 748-3140

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenelle Mazaris

  • Marriage & Family Therapist
  • Plymouth, MI
  • NPI 1700247962
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1700380664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15535 NORTHVILLE FOREST DR APT 251U",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704947",
            "telephone_number": "734-748-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MAIN ST STE 201",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701290",
            "telephone_number": "734-748-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC DRAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "MAZARIS",
        "authorized_official_first_name": "JENELLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "734-748-3140",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexia Holbrook
• Shavel Holcomb
• Reed Holden
• Holding Space Mental Health LLC
• Allison Holecek
• Holistic Family Chiropractic
• Amy Holkeboer
• Demarco Holley, BSW
• Racheal Holliman
• Channelle Hollingsworth

• Marriage & Family Therapist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Marriage & Family Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.